Individual provider Active NPI

Keeli Tritz Gailes, PT, DPT, ATC

  • Physical Therapist
  • Greensboro, NC
National Provider Identifier
1114651528
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18406 Issued in NC
Practice address
1175 Revolution Mill Dr Ste 34L
Greensboro, NC 27405-5168
Phone
(336) 707-9951
NPI assigned
Jul 12, 2022
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18406 NC Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

1175 Revolution Mill Dr Ste 34L
Greensboro, NC 27405-5168

Mailing address

4501 Foreys CT
Graham, NC 27253-8179
Phone (850) 541-2926

Other practice location 1

1647 Saxapahaw Bethlehem Ch Rd
Saxapahaw, NC 27340-9801
Phone (919) 886-7866

Other practice location 2

100 Timberhill Pl Unit 115
Chapel Hill, NC 27514-1962
Phone (919) 585-4588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911001115 NC Practitioner - Physical Therapist in Private Practice 4284174764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ember Continuum L.L.C.Group PAC ID 9032556436, 4 clinicians

Practice addresses (Care Compare)

100 Timberhill PL
Unit 115
Chapel Hill, NC 27514-1962
Phone (919) 585-4588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18406NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ember Continuum LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

100 Timberhill Pl
Unit 115
Chapel Hill, NC 27514
Phone (919) 585-4588

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1114651528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 FOREYS CT",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272538179",
            "telephone_number": "850-541-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 REVOLUTION MILL DR STE 34L",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055168",
            "telephone_number": "336-707-9951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1647 Saxapahaw Bethlehem Ch Rd",
            "address_purpose": "LOCATION",
            "city": "Saxapahaw",
            "state": "NC",
            "postal_code": "273409801",
            "country_code": "US",
            "telephone_number": "919-886-7866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Timberhill Pl Unit 115",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275141962",
            "country_code": "US",
            "telephone_number": "919-585-4588",
            "fax_number": "919-589-4164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAILES",
        "first_name": "KEELI",
        "middle_name": "TRITZ",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "18406",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.